Treatment with Olanzapine, Risperidone or Typical Antipsychotic Drugs in Asian Patients with Schizophrenia

2006 ◽  
Vol 40 (5) ◽  
pp. 437-445 ◽  
Author(s):  
Chul Lee ◽  
Kuang-Hsien Wu ◽  
Hussain Habil ◽  
Yulia Dyachkova ◽  
Phil Lee
Keyword(s):  
Rating Scale ◽  
Severity Of Illness ◽  
Typical Antipsychotic ◽  
Asian Patients ◽  
Olanzapine Treatment ◽  
Menstrual Disturbance ◽  
Symptom Scores ◽  
Report Data ◽  
Outcomes Study ◽  
Typical Treatment

Objective: To examine clinical outcomes in Asian patients with schizophrenia receiving monotherapy with olanzapine, risperidone or typical antipsychotics in naturalistic settings. Method: In this report, data from the first 12 months of the prospective, observational, 3-year Intercontinental Schizophrenia Outpatient Health Outcomes study are presented for patients from participating Asian countries (Korea, Taiwan and Malaysia) who were started on, or switched to, monotherapy with olanzapine (n = 484), risperidone (n = 287) or a typical antipsychotic drug (n = 127) at baseline. Results: At 12 months, overall reduction in the score of Clinical Global Impressions-Severity of Illness rating scale was greatest with olanzapine (p < 0.001 vs typical agents), followed by risperidone (p = 0.007 vs typical agents) treatment. Olanzapine treatment was found to have significantly better effects than typical agents on negative and depressive symptom scores, and significantly greater improvements than risperidone on negative and cognitive symptoms. The occurrence of extrapyramidal symptoms was least likely with olanzapine (p < 0.001 vs typical agents, and p = 0.012 vs risperidone), while the estimated odds of tardive dyskinesia were greatest in the typical treatment group (p = 0.046 vs olanzapine, and p = 0.082 vs risperidone). Mean weight increase was greater for olanzapine-treated patients compared with the other agents (p = 0.030 vs typical agents and p < 0.001 vs risperidone). The risk of menstrual disturbance was relatively high with risperidone when compared with olanzapine treatment (p < 0.001). Conclusions: The results of this observational study indicate that, in Asian patients with schizophrenia, olanzapine may offer benefits when compared with typical agents or risperidone. However, the significantly greater odds of weight gain should be considered in the clinical management of olanzapine-treated patients.

scholarly journals Review of the efficacy of placebo in comparative clinical trials between typical and atypical antipsychotics

2009 ◽  
Vol 31 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Irismar Reis de Oliveira ◽  
Paulo Menezes Nunes ◽  
Domingos Macedo Coutinho ◽  
Eduardo Pondé de Sena
Keyword(s):  
Clinical Trials ◽  
Atypical Antipsychotic ◽  
Atypical Antipsychotics ◽  
Rating Scale ◽  
Study Drug ◽  
Typical Antipsychotic ◽  
The Difference ◽  
Psychiatric Rating Scale ◽  
Efficacy Parameters ◽  
Typical Antipsychotics

OBJECTIVE: To review the efficacy of placebo in comparison with atypical and typical antipsychotics for the treatment of schizophrenia and schizoaffective disorder and to evaluate the pertinence of using placebo in clinical trials with antipsychotics. METHOD: Trials in which the atypical antipsychotics were compared with typical antipsychotics and placebo were included. A search was conducted using the terms "amisulpride", "aripiprazole", "clozapine", "olanzapine", "quetiapine", "risperidone", "sertindole", "ziprasidone" and "zotepine". Main efficacy parameters were calculated using the proportion of "events" (defined as a deterioration or lack of improvement by at least 20% in Positive and Negative Syndrome Scale or Brief Psychiatric Rating Scale) and the pooled relative risk with random effects, with their respective 95% confidence intervals. We also calculated the necessary sample sizes in studies in which the study drug is compared to a typical antipsychotic or placebo. RESULTS: The pooled efficacy rates observed were 40.8%, 34.9% and 21.3% for the atypical antipsychotics, typical antipsychotics and placebo, respectively. One hundred and sixty six patients would have to be included when a new drug is compared with placebo if calculation is based on a difference of 20% found between the atypical antipsychotic and placebo and 2,054 if the difference sought were that found between the atypical antipsychotic and the typical antipsychotic, i.e. 6%. The estimated therapeutic failures would be 115 of the 166 patients when the study drug is compared with placebo, and 1,274 failures in the 2,054 patients when the study drug is compared to the typical antipsychotic. CONCLUSIONS: Placebo controlled studies may reduce the number of individuals exposed to the harmful effects of ineffective drugs.

A Controlled Trial of Extended-Release Guanfacine and Psychostimulants on Executive Function and ADHD

2018 ◽  
Vol 24 (2) ◽  
pp. 318-325 ◽  
Author(s):  
Judy P. M. van Stralen
Keyword(s):  
Executive Function ◽  
Adverse Events ◽  
Extended Release ◽  
Rating Scale ◽  
Controlled Trial ◽  
Severity Of Illness ◽  
P Value ◽  
Serious Adverse Events ◽  
Double Blind ◽  
Stimulant Therapy

Objective: To evaluate the effectiveness of guanfacine extended-release (GXR) versus placebo as adjunct therapy to usual care stimulant therapy in improving executive function in children aged 6 to 12 years diagnosed with ADHD. Method: In this single center, double-blind placebo-controlled crossover trial, subjects continued to take their psychostimulant and were randomly assigned at baseline to receive active treatment or placebo first. Efficacy measures included Behavioural Rating Inventory of Executive Function (BRIEF-P), ADHD Rating Scale IV (ADHD-RS IV), and Clinical Global Impressions of Severity of Illness (CGI-S) and Improvement (CGI-I) scales. Safety measures included adverse events and vital signs. Results: Significant benefits of GXR plus psychostimulant were observed on BRIEF-P ( p value = .0392), ADHD-RS-IV ( p < .0001), CGI-S ( p = .0007), and CGI-I ( p = .003). There were no serious adverse events and no new safety signals. Conclusion: Use of GXR as adjunctive therapy to stimulant therapy significantly improves executive function in children with ADHD.

Longitudinal assessment of disability amongst patients of bipolar and unipolar depressive disorders presenting to a tertiary care center in North India

2022 ◽  
pp. 002076402110701
Author(s):  
Rajesh Sagar ◽  
Mahadev Singh Sen ◽  
Nand Kumar ◽  
Nishtha Chawla
Keyword(s):  
Depressive Disorders ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Disability Evaluation ◽  
Care Center ◽  
Tertiary Care ◽  
Severity Of Illness ◽  
North India ◽  
Longitudinal Assessment ◽  
Over Time

Objectives: To assess and compare the changes in disability scores associated with Bipolar Depression (BD) and Unipolar Depression (UD) over 1 year. Methods: A longitudinal study was taken up in adults diagnosed with unipolar or bipolar depressive disorder with current depressive episode. Diagnosis was made according to Schedule for Clinical Assessment in Neuropsychiatry. Severity scoring was done using Hamilton’s Depression (HAM-D) rating scale and Hamilton’s Anxiety (HAM-A) rating scale. Disability was assessed using Indian Disability Evaluation and Assessment Scale (IDEAS) and London handicap Scale (LHS) at baseline, 6 and 12 months. Results: Sixty participants were recruited (42 UD and 18 BD). No significant differences were seen in socio-demographic parameters, except higher education levels and males being overrepresented in UD. Significant differences at baseline were seen in HAM-D ( p = .001) and HAM-A ( p = .003) scores. The extent of disability was seen to correlate with severity of illness only in case of BD at baseline. No significant differences were seen in the IDEAS scores at baseline. IDEAS score improved at each follow-up assessment ( p < .001). LHS showed significant improvement over time in UD ( p < .001), but not BD ( p = .076). Percentage individuals meeting cut-off for benchmark disability (>40%) were comparable at baseline but were significantly more in the BD at 12-months ( p = .049). Conclusion and implications: Disability in psychiatry occurs equally amongst unipolar and bipolar depressive disorders and tends to improve over time, although the level of improvement may differ. It may not always correspond to severity of illness. These factors should be considered while certifying disability.

scholarly journals T217. MEDICATION ADHERENCE AND ITS CORRELATES AMONG PATIENTS WITH RECURRENT SCHIZOPHRENIA: A LARGE-SCALE STUDY IN CHINA

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S315-S315
Author(s):  
Brendan Ross ◽  
Dongfang Wang ◽  
Chang Xi ◽  
Yunzhi Pan ◽  
Li Zhou ◽  
...  
Keyword(s):  
Hong Kong ◽  
Medication Adherence ◽  
Antipsychotic Medication ◽  
Clinical Characteristics ◽  
Rating Scale ◽  
Severity Of Illness ◽  
Older Age ◽  
Good Adherence ◽  
Acute Period ◽  
Adherence To Medication

Abstract Background The Medication Adherence Rating Scale (MARS) is a rapid, non-intrusive way of measuring adherence to medication in order to improve management of patients with schizophrenia. The current study evaluated the reliability of the Chinese (Mandarin) version of the MARS and explored clinical and demographic correlates to medication adherence in a large sample of patients with recurrent schizophrenia in China. Methods 1198 patients with recurrent schizophrenia were recruited from 37 different hospitals in 17 provinces/municipalities of China and evaluated with the Medication Adherence Rating Scale (MARS), Clinical Global Impression-Severity of illness (CGI-S) and Sheehan Disability Scale-Chinese version (SDS-C). Socio-demographic data included gender, age, marital status, education level, employment status and living with others or alone. Clinical data included duration of illness, number of relapses, and medication use, as well as current stage of disease evaluated by SCID. Pearson correlations were used to examine associations between MARS, socio-demographic, and clinical characteristics. Independent sample T-tests were used to compare MARS score between different socio-demographic and clinical characteristics. Finally, a cut-off score of 6 on the MARS (ranged from 1 to 10) was used to divide the sample into two groups (i.e. MARS score≥ 6 identified good adherence and MARS score&lt; 6 indicated poor adherence). Bivariate logistic regression models with the two groups (MARS score&lt;6 and MARS score≥6) as the dependent variable was used to identify influencing factors of medication adherence. Data processing and analyses were conducted on SPSS 22.0 and Mplus 7.4. Results The MARS showed good internal consistency and psychometric properties. MARS outcomes varied by demographic and clinical characteristics; only 28.5% recurrent schizophrenia patients met the criteria of good adherence to antipsychotic medication. Findings indicated older age (OR=1.04, 95%CI=1.02–1.06), unsteady income (OR=1.79, 95%CI=1.29–2.49), acute period (OR=4.23, 95%CI=3.21–5.59) and a higher CGI-S score (OR=1.44, 95%CI=1.03–2.01) had significantly predictive effects on poor medication adherence. MARS demonstrated good reliability in our sample (Cronbach’s α =0.83; Spearman-Brown = 0.72). Discussion This study of the MARS is unique for a few reasons. First, comparative reports on MARS use in mainland China have not been published internationally; similar tests on reliability and correlation have only been reported in Hong Kong and Taiwan (Hui et al., 2006; Kao and Liu, 2010). Second, in considering demographic and clinical correlates of medication adherence in patients with recurrent schizophrenia, our MARS study broadly represents China with 17 of 27 provinces/municipalities reporting data from multiple geographic regions, with the participation of hundreds of psychiatrists across China. Only 28.5% recurrent schizophrenia patients met the criteria of good adherence to antipsychotic medication in this study. Low levels of good medication adherence in schizophrenia patients are found across Asia, with 27% in Korea meeting the criteria of good adherence (Kim et al., 2006) and 26% in Hong Kong (Hui et al., 2006). Overall MARS total score in our study (3.68 ±2.90) is comparably lower to that of developed countries, as MARS total score had a mean of 6.0 to 7.7 in a UK sample (Fialko et al., 2008; Jaeger et al., 2012), and 5.5 for schizophrenia patients in France (Zemmour et al., 2016). Medication adherence of patients affected by recurrent schizophrenia in China was found to be relatively low. Risk factors for non-adherence to medication in recurrent schizophrenia patients include older age, unsteady income, acute period and severity of illness.

scholarly journals Efficacy and tolerability of mirtazapine versus sertraline: an open, randomized study in acute treatment in patients with major depressive disorder

2014 ◽  
Vol 3 (1) ◽  
pp. 29-34 ◽  
Author(s):  
S Dahal ◽  
SI Ojha ◽  
M Chapagain ◽  
P Tulachan
Keyword(s):  
Sexual Dysfunction ◽  
Large Scale ◽  
Rating Scale ◽  
Randomized Study ◽  
Severity Of Illness ◽  
University Teaching ◽  
Major Depressive ◽  
Hamd Score ◽  
Icd 10 ◽  
Serotonergic Antidepressant

Introduction: Mirtazapine is the first noradrenergic and specific serotonergic antidepressant (NaSSA). It has demonstrated efficacy that is significantly superior to older and newer anti-depressant in the initial weeks of treatment in western studies. The specific pharmacologic profile of mirtazapine also means that it lacks many of the serotonergic side effects, in particular, sexual dysfunction. The effectiveness of sertraline is well established in major depression. Aim: The aim of the study was to compare the anti-depressant efficacy and tolerability of mirtazapine and sertraline in treatment of patients with a diagnosis of major depressive episode attending Psychiatry department of Tribhuvan University Teaching Hospital. Methodology: A total of 60 patients meeting the inclusion criteria were selected. These patients were diagnosed as depression as per the ICD-10 DCR criteria and were randomized to 6 week treatment with either mirtazapine (N=30, 15-45 mg/day) or sertraline (N=30, 50-150mg/day). Efficacy was evaluated by the HAMD scale, Clinical Global Impression scales (CGI) and UKU side effect rating scale was used for any adverse event noted during study period. Assessments were done on baseline and week 2, 4 and 6. Result: The primary efficacy variable (mean absolute change from baseline in HAMD score) showed that mirtazapine was significantly (p < 0.05) more effective than sertraline at assessment during 2 and 4 weeks of the study after which there was no statistically significant differences in efficacy (p >0.05) between two drugs. There was statistically significant reduction in CGI- mean severity of illness rating scale score at 2 week ( p< 0.05) in mirtazapine treated patients compared to sertraline after which reduction of score was similar in both group. Both treatments were well tolerated. Tension (57.6%) , palpitation / tachycardia (26.9%), sexual dysfunction (22.9%) were more frequent in sertraline treated patients compared to nausea / vomiting (26.9%) , sleepiness / sedation (23.0%), increased duration of sleep (23.0%) in mirtazapine treated patients. Conclusion: Mirtazapine was well tolerated and was equally effective as sertraline in reducing depressive symptoms. However, mirtazapine was significantly more effective than sertraline after 2 and 4 week of treatment. The findings need to be confirmed with other large scale studies. DOI: http://dx.doi.org/10.3126/jpan.v3i1.11349 J Psychiatrists’ Association of Nepal Vol .3, No.1, 2014: 29-34

An Open Study of Sertraline in Acute and Continuation Treatment of Depressed Out-Patients

1997 ◽  
Vol 25 (6) ◽  
pp. 340-353 ◽  
Author(s):  
B Van Houdenhove ◽  
P Onghena ◽  
M Flows ◽  
F Janssen ◽  
AR De Nayer ◽  
...  
Keyword(s):  
Major Depression ◽  
Open Study ◽  
Acute Treatment ◽  
Rating Scale ◽  
Severity Of Illness ◽  
Final Visit ◽  
Clinical Global Impression Scale ◽  
Scale Scores ◽  
Insufficient Response ◽  
Continuation Treatment

The efficacy and tolerability of sertraline in 422 out-patients with major depression (DSM-III-R) was evaluated in an open multicentre 8-month study. Patients received sertraline 50 mg/day; if there was insufficient response at week 4, the dose was increased to 100 mg/day. After 8 weeks, 68.6% of patients had responded (≥ 50% reduction in Montgomery Åsberg depression rating scale and clinical global impression scale scores of two or less (improvement of illness) and three or less (severity of illness); of patients receiving continuation treatment, 87.9% maintained at least a partial response at the final visit. The clinical response to the 50 mg/day dose was maintained throughout the acute treatment in 64% of patients. In all, 23% of the patients had mild or moderate drug-related gastrointestinal disturbances, which generally disappeared after 2 weeks. Only 8% of the patients withdrew because of side-effects. Just over half of the patients were taking other psychotropic drugs. Nevertheless the results of this open study are consistent with those of controlled studies in which sertraline was effective and well tolerated, in acute and continuation treatment for major depression, at 50 mg/day in most patients.

BDNF plasma levels in bipolar and unipolar depression

2011 ◽  
Vol 26 (S2) ◽  
pp. 903-903
Author(s):  
L. Dell’Osso ◽  
A. Piccinni ◽  
M. Carlini ◽  
A. Veltri ◽  
S. Baroni ◽  
...  
Keyword(s):  
Plasma Levels ◽  
Rating Scale ◽  
Bipolar Depression ◽  
Biological Marker ◽  
Severity Of Illness ◽  
Unipolar Depression ◽  
Retardation Factor ◽  
Assay Method ◽  
Significant Difference ◽  
Severity Of Depression

IntroductionThere is increasing evidence that Brain-Derived Neurotrophic Factor (BDNF) may be involved in the pathophysiology of depression and the actions of antidepressants.AimsThe aim of the present study was to analyze the relationship between the BDNF plasma levels and clinical variables in unipolar versus bipolar depressed patients.MethodsThirty-three outpatients (17 with unipolar and 16 with bipolar depression) and 15 healthy controls were included in the study. BDNF concentrations were measured with an ELISA assay method. Severity of depression was assessed by means of the 21-item Hamilton Rating Scale for Depression (HRSD) and the Clinical Global Impressions (CGI) Severity of Illness scale.ResultsThe BDNF plasma levels were significantly reduced in patients with unipolar or bipolar depression, with no significant difference between the two groups. Significant and negative correlations were found in the total sample between BDNF levels and the HRSD total scores, the retardation factor scores and CGI “severity of illness” scores. When the same analyses were repeated in each group separately, these findings were confirmed only in patients with bipolar depression.ConclusionsOur results show that lower BDNF levels may be related to both severity of depression and retardation symptoms in bipolar depression. Further studies need to ascertain whether and how the BDNF levels may be associated with any psychopathological dimensions of the depressive state and be used as a biological marker to differentiate bipolar from unipolar depression.

A Controlled Comparative Trial of Mianserin and Diazepam in the Treatment of Anxiety States in Psychiatric Out-Patients

1979 ◽  
Vol 7 (4) ◽  
pp. 285-289 ◽  
Author(s):  
L Conti ◽  
R M Pinder
Keyword(s):  
Rating Scale ◽  
Severity Of Illness ◽  
Comparative Trial ◽  
Placebo Treatment ◽  
Global Rating ◽  
Blurred Vision ◽  
Double Blind ◽  
Baseline Values ◽  
Single Blind ◽  
Hamilton Rating Scale

Forty psychiatric out-patients with primary anxiety entered a double-blind trial comparing 2 weeks of treatment with mianserin 30–60 mg daily or diazepam 15–30 mg daily, followed by 2 weeks of single-blind placebo administration. Both drugs were effective anti-anxiety agents, but mianserin was significantly superior in efficacy as measured by the Physician's Global Rating of Severity of Illness. No differences between treatments were apparent using the Hamilton Rating Scale for Anxiety. There were no significant differences in terms of side-effects, and both drugs increased anticholinergic effects such as dry mouth, blurred vision and constipation over baseline values. With one exception in the mianserin group, all patients who entered placebo treatment became worse.

scholarly journals Gut Microbiota and Depressive Symptoms at the End of CRT for Rectal Cancer: A Cross-Sectional Pilot Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Velda J. Gonzalez-Mercado ◽  
Jean Lim ◽  
Leorey N. Saligan ◽  
Nicole Perez ◽  
Carmen Rodriguez ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Radiation Therapy ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Pilot Study ◽  
Gut Microbiota ◽  
Rating Scale ◽  
Cross Sectional ◽  
Symptom Scores ◽  
Functional Pathways

Background. The role of alterations in gut microbiota composition (termed dysbiosis) has been implicated in the pathobiology of depressive symptoms; however, evidence remains limited. This cross-sectional pilot study is aimed at exploring whether depressive symptom scores changed during neoadjuvant chemotherapy and radiation therapy to treat rectal cancer, and if gut microbial taxa abundances and predicted functional pathways correlate with depressive symptoms at the end of chemotherapy and radiation therapy. Methods. 40 newly diagnosed rectal cancer patients (ages 28-81; 23 males) were assessed for depressive symptoms using the Hamilton Rating Scale for Depression (HAM-D) and provided stool samples for 16S rRNA sequencing. Gut microbiome data were analyzed using QIIME2, and correlations and regression analyses were performed in R. Results. Participants had significantly higher depressive symptoms at the end as compared to before CRT. The relative abundances of Gemella, Bacillales Family XI, Actinomyces, Streptococcus, Lactococcus, Weissella, and Leuconostocaceae were positively correlated (Spearman’s rho = 0.42 to 0.32), while Coprobacter, Intestinibacter, Intestimonas, Lachnospiraceae, Phascolarctobacterium, Ruminiclostridium, Ruminococcaceae (UCG-005 and uncultured), Tyzzerella, and Parasutterella (Spearman’s rho = − 0.43   to − 0.31 ) were negatively correlated with HAM-D scores. Of the 14 predicted MetaCyc pathways that correlated with depressive symptom scores at the end of CRT, 11 (79%) were associated with biosynthetic pathways. Conclusions. Significant bacterial taxa and predicted functional pathways correlated with depressive symptoms at the end of chemotherapy and radiation therapy for rectal cancer which warrants further examination and replication of our findings.

scholarly journals Depressive symptoms among patients with schizophrenia in acute and remission phases

2018 ◽  
Vol 75 (9) ◽  
pp. 849-855
Author(s):  
Amir Peljto ◽  
Danilo Pesic ◽  
Nikos Christodoulou ◽  
Dusica Lecic-Tosevski
Keyword(s):  
Depressive Symptoms ◽  
Acute Phase ◽  
Rating Scale ◽  
Depression Scale ◽  
Severity Of Illness ◽  
Psychotic Symptoms ◽  
Prospective Clinical Study ◽  
Global Functioning ◽  
Affective Symptoms ◽  
Remission Phase

Bacground/Aim. Researchers suggest that among people with schizophrenia, the prevalence of depressive symptoms ranges from 7% to 80%. The rate of depressive symptoms among people with schizophrenia varies widely because of the phase of the disease, type of study applied, rating scale for depressive symptoms and diagnostic criteria. The aim of this research was to determine the prevalence of depressive symptoms and the clinical correlation of depressive symptoms with other clinical parameters (type and severity of psychotic symptoms, severity of illness, insight and global functioning) among patients with schizophrenia in acute and remission phases. Methods. This prospective clinical study enrolled 100 consecutive patients with schizophrenia both in acute and remission phases. Psychometric assessments were made using the Positive and Negative Syndrome Scale (PANSS) for rating the symptoms of schizophrenia, Scale to Assess the Unawareness of Mental Disorder (SUMD), Calgary Depression Scale for Schizophrenia (CDSS), and Global Assessment of Functioning Scale. Results. The prevalence of depressive symptoms among patients with schizophrenia in the acute phase was 23% at the study group, while in the remission phase it was 13%. In the acute phase, the CDSS scale correlated with a depressive and positive subscale of the PANSS scale as well as SUMD scale. In the remission phase, the CDSS scale correlated only with a depressive subscale of the PANSS scale. The CDSS scale did not correlate with the negative subscale of the PANSS scale. The subjective nature of depressive symptoms is more pronounced in the remission phase. Conclusion. Our findings showed that depressive symptoms were more pronounced in the acute psychotic phase than in the remission phase of schizophrenia. Targeted, patient oriented, and algorithm-based approach for treatment management, with taking into account different phenotypic expressions of the disorder (patients with and without affective symptoms) is warranted in patients with schizophrenia.

Sign in / Sign up

Export Citation Format

Share Document